| Human and experimental septic shock are characterized by depletion of lipid droplets in the adrenals. | |
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MedLine Citation:
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PMID: 20665002 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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RATIONALE: Cholesteryl ester deficiency which results in adrenal lipid store depletion has been proposed as a potential mechanism of sepsis associated adrenal insufficiency. OBJECTIVE: We investigated histological abnormalities associated with sepsis in human and mice adrenals. METHODS: From January 2006 to 2008, seven patients who died of septic shock and seven patients with rapidly fatal nonseptic illness were included. Adrenals were sampled within 12 h from death. Adrenals were also taken from 13 lipopolysaccharide (LPS)-challenged mice, 5 cecal ligation and puncture (CLP) mice and 5 controls. We semi-quantitatively analysed intensity of inflammation, necrosis, haemorrhage and lipid depletion. MEASUREMENTS AND MAIN RESULTS: In patients, lipid depletion scores were significantly higher in septic shock than in controls (p = 0.011). In animals, lipid depletion was higher following LPS or CLP than in controls (p = 0.003). In adrenal cortex, in patients and not in animals, global scores for inflammation (p = 0.002), necrosis (p = 0.009) and haemorrhage (p = 0.009) were significantly higher in septic shock than in controls. Similarly, in zona fasciculata, in patients and not in animals, scores for inflammation (p = 0.007), necrosis (p = 0.023) and haemorrhage (p = 0.023) were significantly higher in septic shock than in controls. CONCLUSIONS: This study shows that diffuse lipid depletion in zona fasciculata is a hallmark of human septic shock, experimental endotoxaemia and sepsis. In patients, sepsis was associated with inflammation, necrosis and haemorrhage predominantly in zona fasciculata. |
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Authors:
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Andrea Polito; Geoffroy Lorin de la Grandmaison; Arnaud Mansart; Estelle Louiset; Hervé Lefebvre; Tarek Sharshar; Djillali Annane |
Publication Detail:
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Type: Journal Article Date: 2010-07-28 |
Journal Detail:
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Title: Intensive care medicine Volume: 36 ISSN: 1432-1238 ISO Abbreviation: Intensive Care Med Publication Date: 2010 Nov |
Date Detail:
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Created Date: 2010-10-11 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7704851 Medline TA: Intensive Care Med Country: United States |
Other Details:
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Languages: eng Pagination: 1852-8 Citation Subset: IM |
Affiliation:
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General Intensive Care Unit and Laboratoire d'étude de la réponse neuroendocrine au sepsis EA4342, Service de Réanimation, Raymond Poincaré Hospital (AP-HP), University Versailles Saint-Quentin en Yvelines, 92380, Garches, France. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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